PELVIC ORGAN PROLAPSE
Pelvic Organ Prolapse (POP) is basically a hernia of the vaginal walls allowing for the bowel, bladder, and/or uterus to bulge into the vagina. POP can be painful but typically women will complain of pressure rather than pain, along with other symptoms including the following:
- “Falling out feeling”/downward pressure
- Pain with intercourse
- Difficulty emptying bladder/urination (resulting in double-voiding or frequent urination)
- Difficulty emptying bowel/defecation (resulting in internal splinting or pushing near anus to facilitate evacuation of stool)
- Incontinence may be present but is not necessarily a sign of prolapse
There are 4 stages of prolapse (1=mild to 4=severe) and it is possible to experience a range in severity of symptoms that do not necessarily coincide with the level of prolapse. Typically a grade 3 or 4 depending on symptoms and quality of life is considered to be a surgical case. Grades 1 and 2 can usually improve with physical therapy. Strengthening of the pelvic floor muscles (Kegels) are typically indicated for POP however it is very important to see a pelvic floor physical therapist to ensure you are performing Kegels correctly. Treatment for Bowel and Bladder Retraining are also very beneficial for treating the symptoms of POP. In addition, see treatment under Incomplete Emptying/Post-Void Dribble for self-management strategies.